When the Remedy Becomes the Rash: A Case of Fixed Drug Eruption Due to Paracetamol Use in a Leukemia Patient

Abstract

Background: A Fixed Drug Eruption (FDE) is a localized cutaneous adverse drug reaction marked by the recurrence of lesions at the same site upon re-exposure to a particular drug. While NSAIDs and antibiotics are commonly implicated, paracetamol is also known, though less frequently, to induce FDE.
Case report: A 38-year-old male with chronic myeloid leukemia (CML), well-controlled on dasatinib for the past two years, presented with recurrent fixed drug eruptions after taking paracetamol (650 mg) for fever and cold. The episode was complicated by cellulitis with blister formation on the right arm—a new development for the patient. The FDE lesions appeared at previously affected sites, suggesting reactivation due to paracetamol exposure
Conclusion: This case underscores the need to recognize paracetamol as a potential cause of FDE. It highlights the importance of thorough drug histories, patient education, and safe analgesic alternatives in recurrent FDE, especially in immunocompromised individuals.